Abstract | PURPOSE: METHODS: Two patients from the Dent Neurologic Institute are presented with clinical and magnetic resonance imaging (MRI) correlation. RESULTS: New onset secondarily generalized occipital seizures were noted, with MRI findings consistent with RPLS. Both of the patients had chronic renal failure and a moderate acute exacerbation of chronic hypertension. Other features of hypertensive encephalopathy were lacking, such as headache, nausea, papilledema, and an altered sensorium. Magnetic resonance imaging (MRI) showed edematous lesions primarily involving the posterior supratentorial white matter and corticomedullary junction, consistent with RPLS. With lowered blood pressure, the MRI lesions resolved and the patients became seizure-free without requiring chronic anticonvulsant therapy. CONCLUSIONS: Occipital seizures may represent the only major neurologic manifestation of RPLS due to acute hypertension, especially in patients with renal failure. Other evidence of hypertensive encephalopathy, such as cerebral signs and symptoms, need not be present. Blood pressure elevations may be only moderate. Early recognition of this readily treatable cause of occipital seizures may obviate the need for extensive, invasive investigations. Despite the impressive lesions on MRI, prompt treatment of this disorder carries a favorable prognosis.
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Authors | R Bakshi, V E Bates, L L Mechtler, P R Kinkel, W R Kinkel |
Journal | Epilepsia
(Epilepsia)
Vol. 39
Issue 3
Pg. 295-9
(Mar 1998)
ISSN: 0013-9580 [Print] United States |
PMID | 9578048
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Brain
(pathology)
- Brain Diseases
(diagnosis, pathology, physiopathology)
- Epilepsy, Generalized
(diagnosis, physiopathology)
- Female
- Humans
- Hypertension, Malignant
(diagnosis, physiopathology)
- Magnetic Resonance Imaging
- Middle Aged
- Occipital Lobe
(pathology, physiopathology)
- Syndrome
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